Provider Demographics
NPI:1972893683
Name:KFG OPERATING I, LLC
Entity Type:Organization
Organization Name:KFG OPERATING I, LLC
Other - Org Name:HOPKINS CENTER FOR REHABILITATION & HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES-EDOUARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-360-8083
Mailing Address - Street 1:155 DEAN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2213
Mailing Address - Country:US
Mailing Address - Phone:718-694-6700
Mailing Address - Fax:718-694-6710
Practice Address - Street 1:155 DEAN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-2213
Practice Address - Country:US
Practice Address - Phone:718-694-6700
Practice Address - Fax:718-694-6710
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPKINS VENTURES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7001377N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01533146Medicaid
NY01533146Medicaid